Creative Diagnoses in Dentistry

Reading stuff like this I wonder how much oil changes would cost if they were covered by your car insurance.

“In recent years, I have been seeing more and more creative diagnosis,” Camm told me when I called him at his practice in Washington state. A dentist, he said, might think, “‘Well, the insurance covers this crown, so I’m not hurting this patient, so why don’t I just do it?’ That’s the absolutely wrong approach.”

“Healthy Skepticism”

Healthy Skepticism – My Critique of HealthKit as Both iOS Dev and Registered Nurse:

…interoperability is technically challenging no matter who attempts it. Apple clearly has the capacity to tackle the technical issues if it really wanted to. The central problem for interoperability is one of motivation. Who has the power to compel all the hospitals and EHR vendors in the US to open up read/write access to their medical records?

In my estimation, there are only two entities capable of doing so. The first and obvious one is the government. If Meaningful Use ever mandates one-hundred-percent interoperability, then the industry would have no choice but to comply.

The second entity would be a for-profit company that offers healthcare providers a mutually-benefical partnership. This company would compel hospitals to allow them access, but with a carrot instead of a stick. If there was a way that hospitals could benefit from partnering with an open EHR framework, then they might happily allow their siloed data to flow freely between competing institutions.

All the smartest engineers are figuring out how to get you to click on like buttons and advertising, but sounds like they could be heavily used elsewhere for the good of society.

Daring To Complain About Obamacare

“The nation has been better off,” wrote one friend. “Over 33 million people who did not have insurance are now going to get it.” That’s all fine and good for “the nation,” but what about my $5,400 rate hike (after-tax dollars, I wanted to add, but dared not in this group of previously closeted Mother Teresas)? Another friend wrote, “Yes, I’m paying an extra 200 a month, but I’m okay with doing that so that others who need it can have health care.”

I was shocked. Who knew my friends were such humanitarians? Has Obamacare made it un-P.C. to be concerned by a serious burden on my family’s well-being?

Bitter Pill: Why Medical Bills Are Killing Us

Hugh Jass article on some critical thinking that’s missing from today’s health care debate:

When we debate health care policy, we seem to jump right to the issue of who should pay the bills, blowing past what should be the first question: Why exactly are the bills so high?

I didn’t read it all, but I got the gist. Some people be in cahoots, y’all.

“Trying to Catch His Breath With a Hole-Ridden Safety Net” by Kevin Zeinio

When you’re uninsured you have to make a horrible choice between seeking help and gaining debt, or hoping the problem goes away, risking health problems, and gaining debt.

The mindset of being uninsured is not , well… reassuring. It causes you to take risks that your peers do not need to take. It creates a perpetual fear that anything you do will eat up your life savings or kill you. Indeed, it has for us on one occasion. Nearly a decade ago when my wife was in constant pain for over a day, and after she could not take it anymore, I rushed her to emergency room. They had no clue, it was a worthless visit. They just looked at us dumbfounded and tried to get her to take antibacterials and be on her way. They even did unnecessary x-rays.

All of that was of course billed to us. We had saved up for 4 years to visit her family in Sweden. Every last cent, about $4000 was wiped clean. Apparently the practice of fleecing the uninsured was a commonplace action at this central Californian hospital and we were part of class action lawsuit against them. So many people were involved and the lawyers’ fees so high that we barely recovered anything from it.

“Our Unrealistic Views of Death Through A Doctor’s Eyes” Craig Bowron

To hear that the average U.S. life expectancy was 47 years in 1900 and 78 years as of 2007, you might conclude that there weren’t a lot of old people in the old days — and that modern medicine invented old age. But average life expectancy is heavily skewed by childhood deaths, and infant mortality rates were high back then. In 1900, the U.S. infant mortality rate was approximately 100 infant deaths per 1,000 live births. In 2000, the rate was 6.89 infant deaths per 1,000 live births.

Primary Care Physicians on the Decline

According to the Association of American Medical Colleges, the number of U.S.-born physicians expected to become primary care practitioners – internal medicine, family practice and pediatrics – decreased 31 percent from 2000 to 2010. And the group expects the shortage to get worse.

Also cited for the shortage is the amount of doctors who go towards specialties because they’re more lucrative than being a general practitioner.

Confessions of a Surgeon

Book to be released tomorrow. The Wall Street Journal has an excerpt:

“Get this thing out of my operating room!” The colon stapling device exploded into pieces when I hurled it against the operating room wall. I was fed up with its failure to work as advertised by the manufacturer. The stapler had probably cost less than $100 to make. The hospital paid $300 for it (and then billed the patient, or insurance company, $1,200). Now the thing didn’t even work.

“How Doctors Die” by Ken Murray

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.